Glycemic Improvement with a Fixed‐dose combination of DPP‐4 inhibitor + metformin in patients with Type 2 diabetes (GIFT study). Issue 1 (31st July 2017)

• Record Type: Journal Article
• Authors: Bajaj, Harpreet S.; Ye, Chenglin; Jain, Esha; Venn, Karri; Stein, Eden; Aronson, Ronnie
• Is Part Of: Diabetes, obesity & metabolism. Volume 20:Issue 1(2018)
• Page Start: 195
• Page End: 199
• Publication Date: 2017-07-31
• Subjects: adherence -- DPP‐4 inhibitor -- fixed‐dose combination -- type 2 diabetes; Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.13040
• Languages: English
• ISSNs: 1462-8902

Abstract

Abstract : This study investigates changes in A1C following a switch from dual therapy of metformin and DPP‐4 inhibitor to a fixed‐dose combination (FDC) of metformin + DPP‐4 inhibitor following the introduction of the FDC in the provincial formulary. The LMC Diabetes Registry was queried retrospectively for patients with type 2 diabetes, aged between 18 and 80 years with at least one A1C recorded prior and ≥3 months post‐switch. Five hundred and sixty‐eight subjects with mean age 64 ± 12 years and mean A1C 7.7% ± 1.2% met study criteria. Overall, A1C was 0.3% lower post‐switch to FDC ( P < .01). In stratified analysis, subjects with baseline A1C between 7% and 10% had 0.4% lower A1C ( P < .01), with 31% of these subjects reaching target A1C ≤7%, post‐switch. A1C reduction was greater among patients with a higher baseline pill burden: 0.4% among those using ≥10 pills/day vs. 0.1% for those with <10 pills/day ( P = .02). In this real‐world study, switching to FDC of metformin + DPP‐4 inhibitor was associated with a significant improvement in A1C. Switching to FDC, especially in patients with high pill burden, can improve A1C goal achievement in clinical practice.